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Ukrainians will never know most of their names. In Kharkiv, one of them had just celebrated his 23rd birthday with friends. In the stairwell of the apartment block he lived in with his family, holding a grenade, he took his own life.

In Kyiv, a 55-year-old man called his son to tell him to be a good son. The next day in a park in Kyiv he took his own life. He’d left a note. “It’s nobody’s fault. Simply put, nobody needs me,” it read.

In a village in the Kherson region near Crimea, a young man reportedly went to visit a local priest. Then he hanged himself. The priest he visited wouldn’t let him be buried anywhere but on the edge of the village cemetery.

While his family was buying a handful of ubiquitous blue Kyiv metro tokens, Mykola Sydorchuk, 23 — unlike those above, one of the few to actually be named in Ukrainian news reports — jumped in front of a train.

In western Ukraine, a funeral was held in August for Bogdan Bogdanovich, a popular 36-year-old. Like all these men, Bogdanovich was a veteran of the war in Donbas. Like them, he also took his life.

“In his family it seemed like everything was normal,” Oleksandr Pisarenko, Bogdanovich’s battalion commander, was quoted as saying. “He was a good man, a company commander. But it happened. Unfortunately, that’s life.”

Veterans like Bogdanovich, Sydorchuk and tens of thousands of others might have been feted as heroes when they left for the frontline in eastern Ukraine. But they are coming back to friends, family and a society that doesn’t know how to deal with them. For some of them, it’s too much to bear.

Starting from zero

According to Ukraine’s Interior Minister Arsen Avakov, approximately 500 Ukrainian veterans of the war in Donbas against combined Russian-separatist forces have taken their lives since 2014. The real figure, however, is likely higher: Avakov’s figure, which he said came from Ukraine’s military prosecutor’s office, doesn’t include deaths by suicide before or during deployment, nor does it take into account hidden suicides, like car accidents or drug/alcohol overdoses.

Ihor Kholodylo spent almost two years at the front, and came back to nightmares and flashbacks he wasn’t ready for. The military medic, 52, tells me that Ukrainian society, not to mention veterans themselves and their families, have no idea what it’s like for them to return home. “Society isn’t ready to accept these guys,” says Kholodylo, who now works as a trainer with Pobratymy (Brothers in Arms), a volunteer organisation that works with veterans. “It’s a big problem.”

Veterans coming home from war don’t get nearly enough help to help them cope with the horrors many have seen, Kholodylo tells me. The support offered by the state to veterans and their families is minimal, and other support services are inconsistent in quality and availability. In a World Bank survey of 317 Ukrainian veterans in May 2017, more than a third of soldiers expressed dissatisfaction with the quality of psychologists’ work in Ukraine, while half of them suggested they didn’t use psychological services because they simply weren’t available.

December 2016: a disabled veteran in action during a CrossFit competition for former soldiers injured in the conflict in eastern Ukraine, in Kyiv. (c) Maxym Marusenko/SIPA USA/PA Images. All rights reserved.

The strong stigma attached to mental health issues also makes many veterans, especially men, reticent to seek professional help in the first place, says Kholodylo. The path quickly becomes a dark one for some. “It becomes much easier for these guys to face death,” Kholodylo explains. “They faced death every day on the front, and got used to it.”

As a result, many of Ukraine’s veterans can experience post-traumatic stress disorder (PTSD) — it’s one factor among many, from family breakup and unemployment to alcohol and drug addictions, that pushes some towards suicide. Ukrainian government sources estimate more than one in four Ukrainian veterans of Donbas suffer from PTSD, though the exact figures are disputed.

People like John Quinn, an American physician and conflict medicine specialist who has worked in Donbas, have been pushing Ukraine’s Ministry of Defence and the Ministry of Social Policy (which is responsible for veterans after demobilisation) to acknowledge the brutal power of PTSD and “sub-threshold PTSD” — instances where a traumatised individual meets most, but not all the criteria to be diagnosed with PTSD. “We’ve presented reports and recommendations with ‘addressing PTSD’ high up on the list,” says Quinn. “But it keeps getting pushed down the Defence Ministry’s list of priorities.”

Quinn does stress that there’s been a “massive evolution” in approaches to mental health in Ukraine since the war. More and more people have recognised the need to move away from the Soviet-era approach that has long stigmatised mental health issues, and shift towards using evidence-based best practices such as counselling and therapy. Much of the work over the course of the war, Quinn says, has come from a committed corps of volunteers, though he worries that they’re not always following international best practice.

There is no preventative discharge programme for soldiers and their families, says Chellew, to prepare them for the impact of demobilisation

One thing there’s still not enough of, Quinn notes, is prevention. Ukraine needs more thorough pre-deployment training, says Quinn, to ensure soldiers are well-prepared for the impact being on the frontlines will have on their mental health. Something as simple as a two-hour classroom session for soldiers and their families about what to expect when they come back, he says, would help: “A pinch of prevention is worth a pound of cure.”

This extends to when soldiers are sent home from the front. Ukrainian soldiers don’t go through anything like what happens in western states, where soldiers being discharged or demobilised have to go through a lengthy discharge process that includes debriefing and counseling. While Ukraine’s Ministry of Defence has provided psychological assistance to several thousand soldiers since the beginning of 2017, most of these psychologists are only available in the war zone, and other assistance involves in-patient, “sanatorium and spa” services only available once soldiers have already presented for treatment. There is no preventative discharge programme for soldiers and their families, says Chellew, to prepare them for the impact of demobilisation.

“You can basically walk off the front, hand in your weapon and the base and go home,” says Chellew, a Kyiv-based American medic who has worked in Donbas. “You can be on the front and then 12 hours later be sitting at a bar in Kyiv,” he adds, noting that alcohol is still the only way many people in Ukraine, especially men, cope with mental health issues.

Negative media coverage of veterans takes a toll

Another issue is how Ukrainians and the media talk about veterans. The image that most people have of veterans is far from a positive one, Kholodylo says, and it’s an image that pushes some veterans to the brink. Veterans are often stereotyped as drunks, abusers (reports of domestic violence have increased since 2014) and generally violent, dangerous people. “Our media needs to present the veteran’s image in a correct way,” Chellew, the medic, says.

It’s something that also rankles Kholodylo’s colleague, Ivona Kostyna, who heads up Pobratymy. Kostyna says part of the problem is that the word “veteran” in Ukrainian evokes something very different from today’s veterans. Since the Second World War, says Kostyna, “there’s never really been the concept of a ‘veteran’ in Ukraine.” Even Ukrainian soldiers who fought in Afghanistan for the Soviet Union in the 1980s, she says, didn’t return home carrying the label of “veteran”.

“A veteran, really, is associated in people’s minds here with World War Two vets,” Kostyna adds, “with old men marching on Victory Day,” the 9 May holiday commemorating Soviet victory over the Nazis.

The new image that’s being painted of veterans, Kostyna says, isn’t a pretty one. She recounts how, in 2014 and 2015, she would search online for information about veterans in Ukraine. The results that came back, she tells me, were shocking. Veterans were almost uniformly painted as dangerous drunks, says Kostyna, and a threat to the people around them. “There was just so much that would demoralise an actual veteran looking at this,” she says.

“What’s needed is to tell veterans ‘you’re not alone,’ and give people a true understanding the barriers these men and women are up against”

Unfortunately, some of Ukraine’s top military brass are the ones doing the demoralising. In September 2017, Colonel Oleh Druz, the chief psychiatrist of the Ukrainian defense ministry’s clinical hospital, told members of Ukraine’s parliament that almost 93% of the veterans in Ukraine are a hazard to society, a “hidden enemy” because of their mental health issues.

“Participants in the hostilities can become a threat both to their own families and to entire society after they end their service,” Druz reported to parliamentarians at the committee meeting. “Soldiers’ disorders are characterised by high levels of proneness to conflict, increased aggression, low operability, exacerbation of chronic diseases, alcohol and drug abuse, antisocial behavior, increased levels of suicide, and a reduction in life expectancy.”

Veterans didn’t take too kindly to Druz’s comments: the phrase “One of the 93%” took off among veterans on social media. Druz was quickly suspended from duty for his comments.

But it’ll take more than a suspension to help brighten the image of veterans in Ukraine. John Quinn suggests that a countrywide public health campaign could not only help improve the image of Ukraine’s veterans, but help them better settle back into society after their service is done.

“What’s needed is to tell veterans “you’re not alone,” and give people a true understanding the barriers these men and women are up against,” Quinn says. This kind of campaign should try to reinforce coping strategies among veterans and let veterans know that millions like them in other countries face the same issues, he says. “They need to know they’re not alone, in every sense of the word.”

It’ll be a tough battle, as even the people fighting it acknowledge. Kholodylo notes that it took the United States more than a decade to fully come to terms with and deal with its own veterans after the Vietnam War. “We’re starting from zero,” he says.

“Within a year or two, expect a tsunami,” Kholodylo says, warning that full scope of the issue won’t reveal itself until long after many of the these veterans have come home.

But for Kholodylo, it’s also an opportunity. Embracing Ukraine’s veterans, he says, can act as a way to help Ukrainian society as a whole deal with the legacy of decades of unresolved historical trauma, from the Holodomor and World War Two right up to the still-hot war on the country’s own territory. Embracing veterans and coping collectively with the traumas they’ve witnessed and experienced, says Kholodylo, is a way to help Ukraine as a country heal and move forward after decades of trauma.

“Veterans don’t need sympathy,” Kholodylo adds. “They need dignity.”

If you or someone you know is struggling emotionally or thinking of suicide, please get in touch with a crisis line in your country. A list of some crisis lines can be found here and here.

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